What’s hurting babies in Kettleman City?

KETTLEMAN CITY — Five babies with cleft palates or other grave disabilities were born over a 15-month span in this small farming community off Interstate 5. Three died.

Many parents worry that poisons in the air, water and land are to blame. Their town of 1,500 is wedged between agricultural fields, two highways and a hazardous-waste landfill.

Environmental-justice groups, who oppose a proposed expansion of the landfill, call it a “birth-defect cluster” — a surge in birth defects unlikely to occur by chance. They want an investigation.

But experts say parents may never know what hurt their babies. Apparent spikes in birth defects or cancer cases are notoriously difficult to verify, especially in small communities — and linking them to a specific cause is even harder.

Kings County health officials point out that different types of birth defects are involved, so it’s not yet clear if the birth defect rate was high enough to qualify as a cluster. But at least four of the babies had cleft palates.

Nationally, very few reports of elevated birth defect rates are statistically out of line enough to be identified as a cluster, experts say.

Even if it does qualify as a cluster, an investigation likely would find no clear underlying cause: Birth defect clusters sometimes happen randomly, they say. And many factors — genetics, nutrition, infections, the environment — can contribute to an increase. Untangling one factor from another to find a cause can be nearly impossible, they say.

The debate in Kettleman City has taken on fresh urgency as a hearing approaches on whether to allow an expansion of the Waste Management landfill three miles southwest of town.

On Dec. 7, the Kings County Board of Supervisors is scheduled to consider the company’s expansion request. The hearing is a result of an appeal by environmental groups after the county’s Planning Commission approved the expansion in October. Parents and environmental activists say the plans should be stopped until the birth defects have been investigated.

But investigations of possible clusters often take months, even years, said Lisa Croen, an epidemiologist who helped probe birth defects during 14 years at the California Birth Defects Monitoring Program.

“I know it’s very frustrating for families who have concerns, but that’s the challenge to scientists,” said Croen, who now is in charge of autism studies at Kaiser Permanente’s division of research in Oakland.

The landfill question

For about two decades, families in Kettleman City have voiced concerns about the nearby hazardous-waste plant. It handles things like paints, batteries, solvents and pesticides, among other hazardous materials.

Now, they wonder if there’s a connection between the landfill and the birth defects.

“I don’t say it’s the plant itself, but what else could it be?” Magdalena Romero said in Spanish through an interpreter. Romero’s daughter, America Romero, was born in September 2007 with a cleft palate and other problems from trisomy 13, a chromosome disorder. She died after 41⁄2 months.

Ivan Rodriguez, 28, said he and his wife, Daria Hernandez, took walks in the hills near their home while she was pregnant with their son, Ivan Yhoel. “Once in a while, there would be some bad odors,” Rodriguez said.

Their baby was born with a cleft palate. Now he’s 1, but he can’t eat solid food and must drink formula through a special bottle. Hernandez, 23, said her doctor asked if she used drugs or worked around pesticides that could have caused the birth defect. She had not, she said.The landfill is the only thing with chemicals that his wife was near, Rodriguez said.

The hazardous-waste site may have nothing to do with the birth defects, said Maricela Mares-Alatorre of People for Clean Air and Water of Kettleman City. “But we owe it to those parents to try and find out what’s happening.”

Waste Management spokeswoman Helen Luibel Herrera said the company is “a dedicated community partner, and as such, we want to remain sensitive to the community’s concerns.” Waste Management “feels for those families and what they’re going through and their need for answers,” she said.

But the company stands by its health and safety record of nearly 30 years in the community, she said. The proposal to expand the Kettleman Hills site has gone through extensive environmental studies since 2005, she said. The studies showed no evidence that the site is a direct risk to the community’s health, Herrera said.

Critics of the proposed landfill expansion say government agencies have known about the birth defects in Kettleman City for a year because of a community study.

Greenaction for Health & Environmental Justice, a San Francisco-based environmental organization, and Kettleman City organizations conducted a community health survey that documented birth defects occurring between September 2007 and November 2008. That October, organizers held a community meeting on the issue, and Kings County health officials attended, said Bradley Angel, Greenaction executive director.

They completed the study and released the results in July.

By that time, public debate was already well under way. For example, Dr. Michael MacLean, health officer for Kings County, said Waste Management told him there was a concern in the community about an excess rate of birth defects in July 2008.

The company asked him for birth defect data, he said. And he asked the state Department of Public Health for a report.

County, state and federal agencies should have gone further at that time, Angel said.

“But nothing has happened,” Angel said. “No one has stepped one foot in the town” to investigate.

MacLean did receive the state report, but not until January 2009. It showed low birth-defect rates for Kettleman City from 1998 to 2005 — 2.97 per 1,000 births, compared to 14.85 per 1,000 in Hanford and a national average of about 30. The rate was derived from 337 births in Kettleman City during that period.

According to MacLean, Kettleman City has about 50 births a year. Assuming that rate held steady between September 2007 and November 2008, the five birth defects would result in a rate of about 80 defects per 1,000 babies born. Authorities have yet to release an official rate for that period, however.

MacLean said he asked the state this July for a new report with up-to-date birth-defect rates. He has not received it.

If that report shows a spike in birth defects, MacLean said he would recommend that the county ask the California Birth Defects Monitoring Program to help investigate.

Answers elusive

An investigation into the cause of any birth-defect cluster in Kettleman City could end as did two that involved childhood cancer clusters in McFarland and Earlimart in the 1980s and 1990s: unsolved.

Pinpointing a cause in Kettleman City would be a challenge, and more than the landfill would need to be scrutinized, researchers, activists and residents agree.

Diesel exhaust from trucks traveling along Highway 41 and I-5 mixes with farm pesticides and dust from unpaved sidewalks and nearby fields. Residents drink and bathe in water that contains arsenic in amounts higher than federal standards allow, although not high enough for regulators to ban drinking it.

“I think it’s the cumulative impact of everything surrounding this community,” said Ana Martinez, a Greenaction community organizer in Kettleman City.

Investigations that involve waste sites are particularly difficult, said Croen. In 1997, while she was at the California Birth Defects Monitoring Program, she studied birth defects and mothers’ proximity to Superfund waste sites.

The researchers found a higher risk for neural-tube defects for mothers who lived within a quarter-mile of the Superfund sites, Croen said.

But one of the issues was trying to pinpoint contaminants.

“These waste sites are really chemical soups, so you can’t say it’s this and not that,” Croen said. “It could be the chemical soup, the mixture of things that are combining in a certain way. It may not be just one compound.”

Little angels

A study of the birth defects won’t bring back the babies who died, but their parents want an investigation into the deaths.

“My daughter has passed away, but I think there needs to be studies done to see what’s going on in the community,” Romero said.

Romero, 33, has had a baby, also named America, since her daughter died on Feb. 2, 2008. The baby has no birth defects. Romero has four other living children.

Romero began collecting figurines of angels when America died. The angels protect her babies, she said.

Angel figurines also keep watch in Maria Saucedo and Alejandro Alvarez’s apartment in Avenal, a city of about 17,000 about 15 miles northwest of Kettleman City.

Saucedo, 42, said she lived in Kettleman City for 17 years. She moved to Avenal during her pregnancy, but would visit and stay all day at her mother’s home in Kettleman City. Her baby, Ashley Alvarez, was born in March 2008. The baby had a cleft palate and trisomy 18, a chromosome disorder that made her heart weak. Doctors thought she would live only days. She died from an infection after 101⁄2 months.

Saucedo and Alvarez said they’re convinced that living in Kettleman City is the reason Ashley was born so ill.

And Alvarez added: “A lot of little angels have paid for this.”